Signs of 'sudden' cardiac death may come weeks before -study

November 19, 2013|Reuters

By Ransdell Pierson and Bill Berkrot

Nov 18 (Reuters) - Signs of approaching "sudden" cardiacarrest, an electrical malfunction that stops the heart, usuallyappear at least a month ahead of time, according to a study ofmiddle-age men in Portland, Oregon.

"We're looking at how to identify the Tim Russerts and JimGandolfinis - middle aged men in their 50s who drop dead and wedon't have enough information why," said Sumeet Chugh, seniorauthor of the study and associate director for genomiccardiology at the Cedars-Sinai Heart Institute in Los Angeles.

Russert, a television journalist, died from sudden cardiacarrest at age 58. Gandolfini, an actor, recently died of a heartattack at 51.

In the study, the men had early symptoms like chest pain,shortness of breath and dizziness, fainting or palpitations.

Some 360,000 out-of-hospital cardiac arrests occur each yearin the United States, largely involving middle-aged men, withonly 9.5 percent surviving, according to the American HeartAssociation.

Patients can survive if they are given cardiopulmonaryresuscitation (CPR) immediately and their hearts are jolted backinto normal rhythm with a defibrillator.

Earlier clinical trials have focused only on symptoms orwarnings signs within an hour of such attacks. But Chugh's studyset out to determine whether signs and symptoms occurred as muchas a month before sudden cardiac arrests.

Researchers went back and examined medical records of men 35to 65 years old after they had out-of-hospital attacks. Inaddition, paramedics reaching the scene of fatal attacks askedfamily members what signs and symptoms the patient may have hadin preceding weeks.

Among 567 men who had "sudden" arrests, researchersdetermined 53 percent had symptoms beforehand. Among those withsymptoms, 56 had chest pain, 13 percent had shortness of breathand 4 percent had dizziness, fainting or palpitations.

About 80 percent of symptoms happened between four weeks andone hour before the cardiac arrest, researchers said. Andalthough most men had coronary artery disease, just half hadbeen tested for it before their attacks.

"The findings were entirely unexpected," Chugh said. "Wenever thought more than half of these middle-aged men would havehad warning signs so long before their cardiac arrests.Previously we thought most people don't have symptoms so wecan't do anything about it."

Chugh said most people who have the same kinds of symptomsdon't go on to have cardiac arrests.

"Even so, they should seek medical care," he said. "Themessage here is, if you have these signs or symptoms, pleasedon't ignore them: seek healthcare."

Chugh said he and his colleagues are also attempting toidentify people at risk by comparing biologies of those thathave had sudden cardiac arrests with sample populations inPortland that have never had cardiac arrests.

The new findings, from the 11-year-old "Oregon SuddenUnexpected Death Study," were presented on Tuesday at the annualscientific sessions of the American Heart Association being heldin Dallas.

The researchers are conducting similar studies among women.The ongoing study is being funded by the U.S. Centers forDisease Control and Prevention, AHA and the Doris DukeCharitable Foundation.